Stigma, lack of awareness among reasons women don’t seek help for baby blues

SINGAPORE, May 15 — She was feeding her one-month-old baby girl when Susanna Nickalls had a mental image of her cutting herself and harming her child. She was feeling annoyed because her husband had overslept and missed his turn to feed their daughter.

“I felt let down. My thought process was: ‘If anything happens to me or my baby, my husband would be sorry’,” recalled the 36-year-old, of that day in April 2013.

After shouting at her husband and crying for an hour, Nickalls confided in a good friend about her emotional distress. Persuaded to seek help at the National University Hospital’s Women’s Emotional Health Service, she was diagnosed with mild postnatal depression.

It was then that Nickalls realised she had also suffered from postnatal depression for a few months after giving birth to her son two years earlier.

At that time, she was also easily annoyed, such as when she could not find her shoes and it felt like it was “the worst thing in the world”. She blamed her mood swings on a number of things, unaware that it was postnatal depression.

“I thought it was because of the sleep deprivation and I thought I was failing as a mother,” said Nickalls, a Briton who has been living here for eight years. “I didn’t think that uncontrollable crying was part of postnatal depression. I thought it’s just hormonal.”

Nickalls’ lack of understanding of postnatal depression is not uncommon here. Experts told TODAY many women do not recognise the symptoms, and even those who do resist seeking help out of fear of how others would view them.

Around 6 to 8 per cent of mothers suffer from postnatal depression — this translates to at least nearly 2,000 women, using last year’s figure of 33,000 births.

But since 2008, the Women’s Mental Wellness Service at KK Women’s and Children’s Hospital has seen only about 700 new cases of postpartum depression. The peak was in 2012, when there were almost 100 new cases. Since then, it has averaged at around 83 cases.

The low awareness of postnatal depression was highlighted as an issue to tackle in a coroner’s inquiry last week into the case of Koh Suan Ping, 29, and her two-month-old daughter, Jaelyn Ng, who were found dead at the foot of their Fajar Road block in November last year.

In ruling that Koh took her own life in the fall from height with her baby because she was in postnatal depression, State Coroner Marvin Bay said it was important that new mothers — and those around them — know about the condition and how to find help.

Housewife Amanda (not her real name), 28, who was diagnosed with the condition several months after her second son was born in December 2015, agreed that more people need to learn about the stress of motherhood and postnatal depression.

Between caring for her six-year-old firstborn and household chores, she was tied up with her newborn, leaving her exhausted and agitated at the end of days that typically lasted 17 hours.

“I would cry with my baby and ask, ‘What do you want?’” she said.

Amanda took her frustration out on her husband and they quarrelled nearly every week.

“When I got into a heated argument with my husband, I think of ending my life because it’s so tiring,” she said. “But I kept thinking of my kids, and I can’t just leave them behind. That held me back.”

Amanda said her mother was the one who sensed that something was amiss. “My mom said it might be good for me and my children if I get medical help, rather than wait for things to turn ugly,” she added.

Although she was afraid that she would be judged by others as being mentally ill, Amanda saw a psychiatrist but has kept it a secret from friends.

“I don’t want people to think that I’m not a good mother. And I don’t want my friends to keep their distance away from me, and say, ‘Is she going to go crazy or something?’” she said.

Sharing similar sentiments, Jamie (not her real name), a 31-year-old teacher who also slipped into depression after giving birth to her daughter last August, said the stigma weighs on mothers struggling with the condition.

“The fact that I am uncomfortable to give my name reflects this. I don’t want my parents or my in-laws to get comments from their friends about it,” she added.

Healthcare professionals, these women said, ought to educate parents-to-be on postnatal depression during prenatal check-ups, and share resources, such as information on the different help centres. But it still takes support and vigilance from loved ones after baby is born to ensure mothers who need professional help get it promptly, they added.

Nickalls noted: “Mothers-to-be should not just plan about getting those cute socks, but plan for their mental health care as well.” —TODAY